Deoxycholic Acid and Coronary Artery Calcification in the Chronic Renal Insufficiency Cohort

• Published in: Journal of the American Heart Association 2022-04, Vol.11 (7), p.e022891-e022891
• Main Authors: Jovanovich, Anna, Cai, Xuan, Frazier, Rebecca, Bundy, Josh D, He, Jiang, Rao, Panduranga, Lora, Claudia, Dobre, Mirela, Go, Alan, Shafi, Tariq, Feldman, Harold I, Rhee, Eugene P, Miyazaki, Makoto, Isakova, Tamara, Chonchol, Michel
• Format: Article
• Language: English
• Subjects: Aged; chronic kidney disease; coronary artery calcification; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary Vessels - diagnostic imaging; Cross-Sectional Studies; Deoxycholic Acid; Female; Humans; microbiome; Middle Aged; Original Research; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - epidemiology; Risk Factors; secondary bile acid; Vascular Calcification - diagnostic imaging; Vascular Calcification - epidemiology
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.121.022891

Background Deoxycholic acid (DCA) is a secondary bile acid that may promote vascular calcification in experimental settings. Higher DCA levels were associated with prevalent coronary artery calcification (CAC) in a small group of individuals with advanced chronic kidney disease. Whether DCA levels are associated with CAC prevalence, incidence, and progression in a large and diverse population of individuals with chronic kidney disease stages 2 to 4 is unknown. Methods and Results In the CRIC (Chronic Renal Insufficiency Cohort) study, we evaluated cross-sectional (n=1057) and longitudinal (n=672) associations between fasting serum DCA levels and computed tomographic CAC using multivariable-adjusted regression models. The mean age was 57±12 years, 47% were women, and 41% were Black. At baseline, 64% had CAC (CAC score >0 Agatston units). In cross-sectional analyses, models adjusted for demographics and clinical factors showed no association between DCA levels and CAC >0 compared with no CAC (prevalence ratio per 1-SD higher log DCA, 1.08 [95% CI, 0.91-1.26). DCA was not associated with incident CAC (incidence per 1-SD greater log DCA, 1.08 [95% CI, 0.85-1.39]) or CAC progression (risk for increase in ≥100 and ≥200 Agatston units per year per 1-SD greater log DCA, 1.05 [95% CI, 0.84-1.31] and 1.26 [95% CI, 0.77-2.06], respectively). Conclusions Among CRIC study participants, DCA was not associated with prevalent, incident, or progression of CAC.